Application form

Have you previously been a patient at Sahlgrenska University Hospital/Sahlgrenska International Care AB?

Enter in a format of YYYYMMDD. ex: 19881208

Contact Person
Contact information to physician in the home country or country where the patient has been treated
Medical Care
I'm interested in
How will the medical care be financed?
How did you get in contact with Sahlgrenska International Care?

Fields marked with an asterisk ( * ) are mandatory.

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